Bilateral nerve conduction studies in the evaluation of distal symmetric polyneuropathy

Dupuis, Janae E.; Li, Jay; Callaghan, Brian C.; Reynolds, Evan; London, Zachary

doi:10.1002/mus.26616

Cited by 7 publications

(5 citation statements)

References 7 publications

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“…199,202,203 Studies of both legs may increase diagnostic certainty although symmetrical findings are very common (Cohen's kappa agreement between legs 0.5 and 0.9). 204 Initial studies of the sural to radial nerve amplitude ratio reported a sensitivity and specificity of 90% using the cutoff ratio of <0.4. However, more recent studies report poor sensitivity, equivalent to that of sural responses alone, and less sensitive than medial plantar responses in one cohort.…”

Section: Diabetic Neuropathymentioning

confidence: 99%

“…Prolonged F wave latencies have been proposed as highly sensitive marker of DSPN, although robust diagnostic studies are lacking 199,202,203 . Studies of both legs may increase diagnostic certainty although symmetrical findings are very common (Cohen's kappa agreement between legs 0.5 and 0.9) 204 . Initial studies of the sural to radial nerve amplitude ratio reported a sensitivity and specificity of 90% using the cutoff ratio of <0.4.…”

Section: Polyneuropathymentioning

confidence: 99%

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Electrodiagnostic studies and new diagnostic modalities for evaluation of peripheral nerve disorders

Hannaford,

Paling,

Silsby

et al. 2024

Muscle and Nerve

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Electrodiagnostic studies (EDx) are frequently performed in the diagnostic evaluation of peripheral nerve disorders. There is increasing interest in the use of newer, alternative diagnostic modalities, in particular imaging, either to complement or replace established EDx protocols. However, the evidence to support this approach has not been expansively reviewed. In this paper, diagnostic performance data from studies of EDx and other diagnostic modalities in common peripheral nerve disorders have been analyzed and described, with a focus on radiculopathy, plexopathy, compressive neuropathies, and the important neuropathy subtypes of Guillain‐Barré syndrome, chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), vasculitic neuropathy and diabetic neuropathy. Overall EDx retains its place as a primary diagnostic modality in the evaluated peripheral nerve disorders. Magnetic resonance imaging and ultrasound have developed important complementary diagnostic roles in compressive and traumatic neuropathies and atypical CIDP, but their value is more limited in other neuropathy subtypes. Identification of hourglass constriction in nerves of patients with neuralgic amyotrophy may have therapeutic implications. Investigation of radiculopathy is confounded by poor correlation between clinical features and imaging findings and the lack of a diagnostic gold standard. There is a need to enhance the literature on the utility of these newer diagnostic modalities.

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Section: Diabetic Neuropathymentioning

confidence: 99%

Section: Polyneuropathymentioning

confidence: 99%

Electrodiagnostic studies and new diagnostic modalities for evaluation of peripheral nerve disorders

Hannaford,

Paling,

Silsby

et al. 2024

Muscle and Nerve

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show abstract

“… 3 There are many screening and diagnostic methods for DPN, among which neuroelectrophysiological examination is objective, sensitive and reliable, and is often regarded as the gold standard. 4 , 5 Nerve conduction studies (NCS) are an essential tool in the evaluation of the peripheral nervous system. 6 It determines the functional status of peripheral nerves by examining the muscular nerve conduction function of the affected limb.…”

Section: Introductionmentioning

confidence: 99%

Impaired Vascular Endothelial Function is Associated with Peripheral Neuropathy in Patients with Type 2 Diabetes

Yang¹,

Bai²,

Zhang³

et al. 2022

DMSO

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Purpose It is believed that vascular endothelial dysfunction is involved in the occurrence of cardiovascular disease (CVD), and diabetic peripheral neuropathy (DPN) is associated with flow-mediated dilation (FMD), however, the correlation is still unclear. Aims of the present study is to explore the relationship between DPN parameters and FMD, providing a new approach for the prevention of CVD. Patients and Methods A total of 272 patients with T2DM from the Department of Endocrinology of The First Hospital of Lanzhou University according to the grading criteria were selected. FMD was measured by a new vascular ultrasound system and patients were divided into FMD>7%, 4%≤FMD≤7%, and FMD<4% groups. The Toronto Clinical Scoring System (TCSS) was used to assess the severity of DPN. The nerve conduction studies (NCS) assessed large fibre neuropathy by nerve conduction velocity (CV), compound muscle action potential (CMAP) amplitude (Amp), and distal motor latency (DML). SPSS 25.0 was used for statistical analysis. Results TCSS evaluation revealed that the percentage of patients with severe nerve injury was significantly higher in FMD<4% (70%) compared to FMD>7% (2%). Among the TCSS indicators of all subjects, the proportion of temperature disturbance was the most (73%), and joint position disturbance was the least (0). TCSS scores were negatively correlated with FMD ( r=−0.756, p<0.001 ). More interesting, in FMD<4% group, CV and Amp were positively correlated with FMD, while DML was negatively correlated ( p<0.05 ). Linear regression analysis model showed that different systolic blood pressure (SBP), triglyceride (TG), TCSS and CV had statistically different effects on FMD. Conclusion High TCSS score and decreased CV of common peroneal and tibial nerves are risk factors of FMD injury, which provide potential value for timely prevention and treatment of cardiovascular diseases.

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“…Diagnostic guidelines have been established to standardize diagnostic procedures and scientific reporting [ 5 ]. Algorithms include clinical and electrodiagnostic testing, serological markers, and skin and/or peripheral nerve biopsies [ 6 , 7 ]. Sural nerve biopsy is recommended to detect demyelination and axonal damage, and to differentiate inflammatory disorders (e.g.…”

Section: Introductionmentioning

confidence: 99%

Myelination, axonal loss and Schwann cell characteristics in axonal polyneuropathy compared to controls

et al. 2021

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Introduction Polyneuropathy is a debilitating condition characterized by distal sensory and motor deficits. Schwann cell dysfunction and axonal loss are integral factors in pathophysiology and disease progression of polyneuropathy. Aims The aim of this study was the assessment of Schwann cell characteristics, nerve fibers and myelination parameters in polyneuropathy patients compared to controls. Methods Nerve tissue was obtained from polyneuropathy patients (n = 10) undergoing diagnostic sural nerve biopsies. Biopsies of healthy peripheral nerves (n = 5) were harvested during elective sural nerve grafting for chronic peripheral nerve lesions. Exclusion criteria for the healthy control group were recent neurological trauma, diabetes, neurological and cardiovascular disease, as well as active malignancies and cytotoxic medication within the last 12 months. The over-all architecture of nerve sections and myelination parameters were histomorphometrically analyzed. Immunofluorescent imaging was used to evaluate Schwann cell phenotypes, senescence markers and myelination parameters. Results Histomorphometric analysis of nerve biopsies showed significant axonal loss in polyneuropathy patients compared to controls, which was in accordance with the neuropathological findings. Immunofluorescent staining of Schwann cells and myelin basic protein indicated a significant impairment of myelination and lower Schwann cell counts compared to controls. Phenotypic alterations and increased numbers of non-myelinating p75-positive Schwann cells were found in polyneuropathy patients. Discussion This study provided quantitative data of axonal loss, reduced myelination and Schwann cell dysfunction of polyneuropathy patients compared to neurologically healthy controls. Phenotypic alterations of Schwann cells were similar to those seen after peripheral nerve injury, highlighting the clinical relevance of Schwann cell dysfunction.

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Bilateral nerve conduction studies in the evaluation of distal symmetric polyneuropathy

Cited by 7 publications

References 7 publications

Electrodiagnostic studies and new diagnostic modalities for evaluation of peripheral nerve disorders

Electrodiagnostic studies and new diagnostic modalities for evaluation of peripheral nerve disorders

Impaired Vascular Endothelial Function is Associated with Peripheral Neuropathy in Patients with Type 2 Diabetes

Myelination, axonal loss and Schwann cell characteristics in axonal polyneuropathy compared to controls

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